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General Splinting Techniques (Internal Medicine)
Question 1 A 53-year-old woman falls backward while in-line skating and lands on her outstretched arm. She is seen with pain, swelling, and abrasions of her arm. A radiograph reveals nondisplaced midshaft fractures of the ulna and radius. Which of the following is true regarding complications of splinting? Answered: e. Stiff joints are almost inevitable after splinting but can be minimized by appropriate positioning of the joint: generally so that tendons and ligaments are in lengthened positions. ________________________________________ Question 2 Which of the following should not be done while applying the splint? Answered: c. Use your finger tips to gently mold the plaster to the extremity. ________________________________________ Question 3 A 53-year-old woman falls backward while in-line skating and lands on her outstretched arm. She is seen with pain, swelling, and abrasions of her arm. A radiograph reveals nondisplaced midshaft fractures of the ulna and radius. A fiberglass long arm splint is applied with use of several layers of Webril for padding. Which of the following is true of care after application of the splint? Answered: a. Radiographs showing two views of the fracture should be taken to ensure that fracture reduction was maintained during application of the splint. ________________________________________ Question 4 Which of the following statements regarding potential complications of splinting is true? Answered: a. Pressure sores can result from wrinkles in the stockinette. ________________________________________ Question 5 A 53-year-old woman falls backward while in-line skating and lands on her outstretched arm. She is seen with pain, swelling, and abrasions of her arm. A radiograph reveals nondisplaced midshaft fractures of the ulna and radius. Which of the following is true about splints? Answered: (INCORRECT) a. Fiberglass splints are stronger than plaster. 答案應該是Plaster splints should not be molded with use of hot water. Rationale: Fiberglass and plaster splints have similar strength depending on the thickness of the splint, although fiberglass is lighter weight. The advantage to plaster is that it is generally easier to mold than prefabricated fiberglass splint material. Both types of splint material set up after exposure to water in an exothermic (heat-producing) reaction, although the reaction is more pronounced with plaster. Hot water should not be used to set up splint material, because the exothermic reaction and heat of the water can cause patient burns. Hot water is associated with faster set-up times and may not allow sufficient time to mold the splint well. Fiberglass or plaster can be used for lower-extremity splints-both have sufficient strength if they include enough layers. The palm of the hand should be used to mold the splint, because finger indentations in the splint can cause pressure injury to soft tissues. ________________________________________ Question 6 Which of the following is not required before splinting? Answered: c. Reduce swelling with a compression bandage. ________________________________________ Question 7 Which of the following are contraindications for splinting? Answered: d. All of the above ________________________________________ Question 8 A 53-year-old woman falls backward while in-line skating and lands on her outstretched arm. She is seen with pain, swelling, and abrasions of her arm. A radiograph reveals nondisplaced midshaft fractures of the ulna and radius. Which of the following statements regarding management of her fracture is true? Answered: c. Her examination should include a thorough neurologic and vascular examination of the hand. ________________________________________ Question 9 Which of the following is a benefit of using prefabricated fiberglass splints instead of plaster splints? Answered: c. Prefabricated fiberglass splinting material is strong and lightweight.